Nature Reviews Nephrology最新文献

Pregnancy-associated acute kidney injury — consensus report of the 32nd Acute Disease Quality Initiative workgroup 妊娠相关急性肾损伤——第32届急性疾病质量倡议工作组共识报告

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-07-18 DOI: 10.1038/s41581-025-00979-6

Cathy Nelson-Piercy, Nattachai Srisawat, Kianoush Kashani, Nuttha Lumlertgul, Raghavan Murugan, Harin Rhee, Raj Chakravarthi, Tarakeswari Surapaneni, Anjali Acharya, Ghada Ankawi, Kate Bramham, Jorge Cerda, Katherine Clark, Rolando Claure-Del Granado, Swarnalata Gowrishankar, Valerie Luyckx, Shina Menon, Carlos E. Poli-de-Figueiredo, Raja Ramachandran, Manisha Sahay, Srinivas Samavedam, Rasha Shemies, Manjunath S. Shetty, Kate Wiles, Lizemarie Wium, Vin-Cent Wu, Manjusha Yadla, Claudio Ronco, Ravindra L. Mehta, Marlies Ostermann

{"title":"Pregnancy-associated acute kidney injury — consensus report of the 32nd Acute Disease Quality Initiative workgroup","authors":"Cathy Nelson-Piercy, Nattachai Srisawat, Kianoush Kashani, Nuttha Lumlertgul, Raghavan Murugan, Harin Rhee, Raj Chakravarthi, Tarakeswari Surapaneni, Anjali Acharya, Ghada Ankawi, Kate Bramham, Jorge Cerda, Katherine Clark, Rolando Claure-Del Granado, Swarnalata Gowrishankar, Valerie Luyckx, Shina Menon, Carlos E. Poli-de-Figueiredo, Raja Ramachandran, Manisha Sahay, Srinivas Samavedam, Rasha Shemies, Manjunath S. Shetty, Kate Wiles, Lizemarie Wium, Vin-Cent Wu, Manjusha Yadla, Claudio Ronco, Ravindra L. Mehta, Marlies Ostermann","doi":"10.1038/s41581-025-00979-6","DOIUrl":"https://doi.org/10.1038/s41581-025-00979-6","url":null,"abstract":"Acute kidney injury (AKI) during pregnancy and the postpartum period, known as pregnancy-associated AKI (PrAKI), is an important health concern and driver of health inequity worldwide. Causes of PrAKI include sepsis, autoimmune disorders and pregnancy-specific pathologies such as hypertensive disorders. Common risk factors include maternal comorbidities and use of nephrotoxic medications. PrAKI accounts for a substantial proportion of maternal mortality and morbidity, particularly in low-income and middle-income countries, and may also adversely affect the fetus, resulting in death, premature birth and small for gestational age. In this Consensus Statement, we present recommendations on the causes, diagnosis, management and follow-up of PrAKI from the 32nd Acute Disease Quality Initiative meeting, which involved international experts in obstetrics, midwifery, obstetric medicine, paediatrics, internal medicine, anaesthesiology, nephrology and critical care. We suggest that pregnant and postpartum women at a high risk of PrAKI should be identified to enable prevention, surveillance and timely diagnosis. The multidisciplinary management of these patients should be tailored to treat their specific causes of PrAKI to optimize short-term and long-term neonatal and maternal outcomes. Further observational and interventional studies are needed to address existing gaps in knowledge of PrAKI and improve maternal and fetal outcomes.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"96 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Kidney health outcomes of hypertensive disorders of pregnancy 妊娠期高血压疾病对肾脏健康的影响

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-07-18 DOI: 10.1038/s41581-025-00977-8

Giorgina Barbara Piccoli, Massimo Torreggiani, Nora Schwotzer, Gianfranca Cabiddu, Rossella Attini, Alejandra Orozco, Rasha Shemies, Shilpanjali Jesudason, Fadi Fakhouri, Vesna D. Garovic

{"title":"Kidney health outcomes of hypertensive disorders of pregnancy","authors":"Giorgina Barbara Piccoli, Massimo Torreggiani, Nora Schwotzer, Gianfranca Cabiddu, Rossella Attini, Alejandra Orozco, Rasha Shemies, Shilpanjali Jesudason, Fadi Fakhouri, Vesna D. Garovic","doi":"10.1038/s41581-025-00977-8","DOIUrl":"https://doi.org/10.1038/s41581-025-00977-8","url":null,"abstract":"Hypertensive disorders of pregnancy (HDPs), including pre-eclampsia (PE), are frequent, affecting 8–10% and 2–4% of all pregnancies, respectively. Among HDPs, PE is the best characterized and most frequently studied — it is a heterogeneous disease with different clinical phenotypes reflecting distinct underlying mechanisms that ultimately result in widespread endothelial dysfunction and systemic damage. HDP clinical remission is common after delivery, but the long-term health of women with a history of HDP is adversely affected compared with that of women with normotensive pregnancies. The relationship between HDP and kidney health is bidirectional: chronic kidney disease (CKD) increases the risk of HDP, and HDP raises the risk of future CKD. To what extent this increased risk of CKD after HDP is due to pre-existing CKD that is unmasked by pregnancy and/or whether HDP is a causal factor in CKD remains unclear. CKD is diagnosed in up to 20% of women after PE, and the lifetime risk of kidney failure after one episode of PE is 4–8 times higher than that of the general population, increasing further with PE recurrence. These risks are cross generational, as women born prematurely from pregnancies complicated by PE and fetal growth restriction can have low nephron mass, which would not only increase their lifetime risk of CKD but also their risk of developing PE in their own pregnancies.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"30 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patient involvement in nephrology research 患者参与肾脏病研究

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-07-14 DOI: 10.1038/s41581-025-00987-6

Nicole Scholes-Robertson, Allison Jaure

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The catastrophic costs of chronic kidney disease 慢性肾脏疾病的灾难性代价

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-07-02 DOI: 10.1038/s41581-025-00978-7

Priya Pais, Valerie Luyckx, Susmita Chatterjee, Beverley M. Essue

引用次数: 0

Superior efficacy of empagliflozin and finerenone combination therapy versus monotherapy in patients with CKD and T2DM 恩格列净和芬尼酮联合治疗CKD和T2DM患者优于单药治疗

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-06-27 DOI: 10.1038/s41581-025-00986-7

Ellen F. Carney

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Harnessing plant thylakoids to restore cellular function in AKI 利用植物类囊体恢复AKI的细胞功能

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-06-23 DOI: 10.1038/s41581-025-00981-y

Susan J. Allison

{"title":"Harnessing plant thylakoids to restore cellular function in AKI","authors":"Susan J. Allison","doi":"10.1038/s41581-025-00981-y","DOIUrl":"https://doi.org/10.1038/s41581-025-00981-y","url":null,"abstract":"The kidney tubule is highly metabolically active and requires a constant supply of ATP for electrolyte and solute transport. Acute kidney injury (AKI) is associated with mitochondrial damage and metabolic disturbances, which impedes these processes. In particular, downregulation of quinolinate phosphoribosyltransferase (QPRT) leads to reduced levels of NAD⁺ — a key coenzyme for mitochondrial repair and ATP generation and a substrate for cellular antioxidant systems — that, in turn, lead to oxidative stress. Yao Lei and colleagues now demonstrate the ability of thylakoid-containing liposome vesicles to rescue AKI-associated energy deficits, increase ATP synthesis and suppress oxidative stress. “This work establishes a therapeutic paradigm for diseases characterized by compromised energy metabolism and dysregulated oxidative stress,” says lead author, Hai-Yan Xie.Xie explains that her team has long drawn inspiration from native cellular components to construct bionic systems for biomedical applications. “When considering possible solutions for AKI treatment, we discovered that thylakoids — essential organelles for energy conversion in plant cells — possess a photosynthesis-driven electron transport chain and express abundant QPRT, which enables them to efficiently synthesize NAD⁺ and its derivatives such as NADH and NADPH,” she explains. “We hypothesized that thylakoids could be used to correct the metabolic dysfunction of AKI and reverse disease progression.”","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"269 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144341228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Leveraging data as a patient–scientist: frustrations and opportunities 作为病人科学家利用数据：挫折和机遇

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-06-19 DOI: 10.1038/s41581-025-00968-9

Julio Saez-Rodriguez

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Effects of microplastics and nanoplastics on the kidney and cardiovascular system 微塑料和纳米塑料对肾脏和心血管系统的影响

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-06-19 DOI: 10.1038/s41581-025-00971-0

Yu-Hsuan Lee, Cai-Mei Zheng, Ying-Jan Wang, Yung-Li Wang, Hui-Wen Chiu

{"title":"Effects of microplastics and nanoplastics on the kidney and cardiovascular system","authors":"Yu-Hsuan Lee, Cai-Mei Zheng, Ying-Jan Wang, Yung-Li Wang, Hui-Wen Chiu","doi":"10.1038/s41581-025-00971-0","DOIUrl":"https://doi.org/10.1038/s41581-025-00971-0","url":null,"abstract":"Microplastics and nanoplastics are ubiquitous environmental pollutants that contaminate air, food and water supplies, resulting in widespread human exposure and potential health risks. Varying concentrations of particulate plastics have been identified in human tissues and body fluids, including the heart, kidney, liver, brain, blood and urine. Studies in animal models and human cells have reported that particulate plastics can induce oxidative stress, cell death and inflammation as well as disrupt metabolism and immune function. They have also been shown to have toxic effects on kidney and cardiovascular cells, which are exacerbated by the presence of other environmental contaminants such as heavy metals. Patients with kidney failure might be at risk of increased exposure to particulate plastics during dialysis. Furthermore, clinical evidence suggests that particulate plastic exposure is a risk factor for cardiovascular disease. Approaches to mitigating such exposure include degradation via abiotic and biotic processes, improved waste management and water filtration approaches and use of alternative materials. Further research into the fate, toxicity and health consequences of particulate plastics is imperative to inform strategies to address this escalating environmental and health concern.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"36 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fibroblast activation and heterogeneity in fibrotic disease 纤维化疾病中的成纤维细胞活化和异质性

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-06-19 DOI: 10.1038/s41581-025-00969-8

Xiaoyao Zhang, Yuxi Zhang, Youhua Liu

{"title":"Fibroblast activation and heterogeneity in fibrotic disease","authors":"Xiaoyao Zhang, Yuxi Zhang, Youhua Liu","doi":"10.1038/s41581-025-00969-8","DOIUrl":"https://doi.org/10.1038/s41581-025-00969-8","url":null,"abstract":"Fibroblasts are a special type of interstitial cell that has an essential role in maintaining the structural framework of tissues and organs. In response to injury, fibroblasts are activated and produce large amounts of extracellular matrix proteins. Fibroblast activation has a crucial role in tissue repair and wound healing. However, uncontrolled and persistent activation of fibroblasts ultimately leads to fibrotic diseases of organs such as the kidney, liver, lung and heart. Activated fibroblasts predominantly originate from the local activation and expansion of resident fibroblasts and pericytes. A diverse array of extracellular cues, including soluble factors, extracellular vesicles, matricellular proteins and mechanical stiffness, induce fibroblast activation after tissue injury. Fibroblast activation primarily takes place in the fibrogenic niche, a unique tissue microenvironment in which fibroblasts interact with injured parenchymal cells, inflammatory cells and endothelial cells. The fates of activated fibroblasts, including apoptosis, senescence, dedifferentiation and lineage reprogramming, determine the outcome of tissue repair and organ fibrosis. Potential therapeutic strategies for fibrotic diseases include disrupting the formation of the fibrogenic niche, inhibiting fibroblast activation, promoting fibroblast depletion, accelerating fibrosis resolution or promoting tissue repair and regeneration.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"24 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nephrogenomics, precision medicine and the role of genetic testing in adult kidney disease management 肾基因组学、精准医学和基因检测在成人肾脏疾病管理中的作用

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-06-16 DOI: 10.1038/s41581-025-00970-1

Ilias Bensouna, Alice Doreille, Marine Dancer, Anne-Sophie Lebre, Thomas Robert, Laurent Mesnard

{"title":"Nephrogenomics, precision medicine and the role of genetic testing in adult kidney disease management","authors":"Ilias Bensouna, Alice Doreille, Marine Dancer, Anne-Sophie Lebre, Thomas Robert, Laurent Mesnard","doi":"10.1038/s41581-025-00970-1","DOIUrl":"https://doi.org/10.1038/s41581-025-00970-1","url":null,"abstract":"Genetic investigations in nephrology have long been viewed as the prerogative of paediatricians or restricted to archetypal genetic nephropathies with highly penetrant variants affecting young adults. However, genetic testing has emerged as a pivotal tool in the field of adult nephrology, with the ability to revolutionize the understanding and management of adult kidney diseases. Here, we explore the multifaceted role of genomic testing (such as exome or genome sequencing) in chronic kidney disease, shedding light on current genetic findings for reframing diagnostic paradigms and tailoring treatment strategies. Genomic testing has enhanced our comprehension of kidney diseases of unknown origin by showing that ~20% are attributable to kidney Mendelian genetic disorders with as yet unsuspected phenocopies. Beyond genetic counselling, genetic integration can optimize therapeutic interventions, kidney transplantation and kidney disease prevention, both in index cases and in at-risk family members. Furthermore, the emerging field of rapid nephrogenomics promises streamlined diagnosis and management, with a potential impact on early therapeutic strategy. Importantly, although costs continue to decrease, the integration of genomic technologies in nephrology practice raises several ethical concerns, especially regarding variants of uncertain significance, and incidental or secondary findings. Establishing multidisciplinary frameworks should maximize the potential of nephrogenomics to improve patient outcomes.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"3 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0